HOSPITALS could be forced to shut at night unless they urgently change they way work, the Cheshire- based leader of Britain's doctors has warned.

HOSPITALS could be forced to shut at night unless they urgently change they way work, the Cheshire- based leader of Britain's doctors has warned.

From August next year, under the European Working Time Directive (EWTD), junior doctors must spend no more than 58 hours a week working or in a hospital on call.

This compares with the current maximum of 72 hours a week.

James Johnson, new chairman of the British Medical Association and a consultant surgeon at Halton Hospital, warned: "In a year's time there is going to be a quantum leap in the problems hospital are going to have to face.

"It is going to be impossible to keep all hospitals currently open 24 hours a day open at night and weekends."

He said it was difficult to see how Government targets would be met as outpatient and non-urgent services during the day would suffer if doctors used up their maximum number of working hours simply covering nights and weekends.

Mr Johnson said one solution would be to have a multi-disciplinary team providing night cover for each hospital.

Currently, each speciality has someone, often a trainee doctor, on call to cover evenings and weekends for their patients within the hospital.

Instead, said Mr Johnson, the multi-disciplinary team would deal with the needs of all patients throughout the hospital.

They would need the skills to deal with problems such as heart failure and complications after surgery that could typically arise overnight.

Mr Johnson said the Government was already piloting this idea in a couple of hospitals "but there needs to be a greater sense of urgency".

Local hospitals said they have already made good progress in preparing for the introduction of the EWTD.

Graham Hewitt, director of human resources at Wirral Hospitals NHS Trust, said: "We have already reviewed many of our out-of-hours rotas and, where possible, have introduced shift systems that give us a better chance of being compliant with the directive.

"We are also participating in a national pilot scheme called 'Hospital at Night', that aims to address some of the issues the directive brings with it.

"This involves reviewing what work we do at night and seeing whether some of it can be carried out at other times.

"The second stage is to look at what skills are needed for this work and then thinking about how we can use staff from a range of disciplines to cover the skills required, with no loss of quality of care to our patients."

Kath Holbourn, acting chief executive of North Cheshire Hospitals NHS Trust, which includes Warrington and Halton Hospitals, said: "The European Working Time Directive will influence major changes in how services will be provided in future years.

"We are committed to its objectives and plans are well under way to ensure we are compliant by August 2004."

At Alder Hey Children's Hospital in Liverpool, the message was the same.

A spokeswoman said: "We recognise this is a challenge for all hospitals, but we have to find a solution.

"We have got a group of doctors, nurses and managers working together to identify the problem areas and solutions.

"For example, there is a lot of talk about developing the role of nurses. It's about working as a team."